§1784A Examination and Treatment for Emergency Medical Conditions and Women in Labor

Summary

A Department hospital that has an emergency room must give anyone who comes to the hospital or its campus and asks for care a medical screening exam. The exam must use the emergency room’s usual tests and services to find out if the person has an emergency medical condition. If the hospital finds an emergency medical condition, it must either treat the person with the staff and equipment it has until the condition is stabilized, or transfer the person to another medical facility under the rules below. If the hospital offers the needed care or a transfer and explains the risks and benefits, but the person (or their representative) refuses, the hospital meets its duty as long as it tries to get a written informed refusal. A hospital may not transfer an unstable patient unless the patient (or a legally responsible person) asks for transfer in writing, or a Department physician certifies that the expected medical benefit of transfer outweighs the increased risks (for labor, this includes the unborn child), or, if no physician is present, a qualified medical person signs a certification after consulting a physician who later signs it. That certification must summarize the risks and benefits. An appropriate transfer means the sending hospital gives all care it can to reduce risk, the receiving facility has room and agrees to accept the patient, the sending hospital sends all available medical records about the condition (observations, diagnosis, treatments, test results, and the written request or certification), and the move is done by qualified staff with proper transport and life support. The Secretary will charge for care using the billing rules already allowed by law. Campus — the hospital grounds and nearby areas up to 250 yards away, or other areas the Secretary says count. Emergency medical condition — a sudden, serious health problem that needs immediate care or, for a pregnant woman, a stage of labor that makes safe transfer unlikely or risky. To stabilize — give the treatment needed so the condition is not likely to get worse during transfer; for labor, to deliver the baby and placenta. Stabilized — the condition is unlikely to worsen during transfer, or the woman has delivered (including the placenta). Transfer — moving a patient off the hospital’s premises at the direction of hospital staff, except if the person is dead or leaves on their own.